John Clark Christiansen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1639 Issued in WY

Practice address

2120 Logan Ave
Cheyenne, WY 82001-4131

Phone

(307) 638-8071

NPI assigned

May 31, 2022

Last updated

Oct 2, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sunlight Dental

  • Dental Clinic/Center
  • Cheyenne, WY
  • NPI 1912642604
  NPD
• Mountain Smiles - Christiansen Dental, PLLC

  dba Christiansen Dental

  • Dentist
  • Centennial, CO
  • NPI 1518715150
  NPD
• Brush Family Dentistry PC

  • Dentist
  • Brush, CO
  • NPI 1790148369
  NPD (past)
• Brush Family Dentistry, PLLC

  • General Practice Dentistry
  • Brush, CO
  • NPI 1639441033
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1427797323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9085 E MINERAL CIR STE 160",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801123499",
            "telephone_number": "303-790-9323",
            "fax_number": "303-792-5727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 LOGAN AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820014131",
            "telephone_number": "307-638-8071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "302 Cameron St",
            "address_purpose": "LOCATION",
            "city": "Brush",
            "state": "CO",
            "postal_code": "807232017",
            "country_code": "US",
            "telephone_number": "970-842-2858",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9085 E Mineral Cir Ste 160",
            "address_purpose": "LOCATION",
            "city": "Centennial",
            "state": "CO",
            "postal_code": "801123499",
            "country_code": "US",
            "telephone_number": "303-790-9323",
            "fax_number": "303-792-5727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISTIANSEN",
        "first_name": "JOHN",
        "middle_name": "CLARK",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-31",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00205130",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "1639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIS",
            "identifier": "00205130",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "00205130",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Thomas Christian, MD
• Ashley Christiansen
• Chad Christiansen, DDS
• Christine J Christiansen, LAT
• James Clark Christiansen
• Christina Anderson RDN LLC
• Michael A Christoffersen
• Allan Christofferson
• Scott Christofferson
• Jared Christopherson, D.D.S

• General Practice Dentistry in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• General Practice Dentistry in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.